You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in the Original Medicare Plan. You may want to consider a Medicare Prescription Drug Plan (Part D) to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall. There are things you should consider to help you meet your needs.
Things to Consider for Each Option
Cost--What will you pay out-of-pocket, including Premiums?
Benefits--Are extra benefits and services, like eye exams or hearing aids covered? (These may be covered by some plans.)
Doctor and hospital choice--Can you see the doctor(s) you want? Are they accepting new patients? Do you need a Referral to see a specialist? Can you go to the hospital you want? Do you pay less to go to certain doctors or hospitals?
Convenience--Where are the doctors' offices? What are their hours? Is there paperwork?
Travel--Do you spend part of each year in another state? Will the plan cover you there?
Prescription drugs-- What will your prescription drugs cost under the plan's Formulary (list of covered drugs)? What are your drug needs?
Pharmacy choice--What pharmacies can you use?
Quality of care--Quality of care varies among plans, doctors, hospitals, and other health care providers. Giving good quality health care means doing the right thing, at the right time, in the right way, for the right person--and getting the best possible results. Quality information to help you make the best choices for your well-being is available at www.medicare.gov on the web, or by calling 1-800-MEDICARE (1-800-633-4227).
(Primary Source: Centers for Medicare and Medicaid Services - Medicare and You Handbook. This content may have been enhanced by Q1Group LLC to include further examples, explanations, and links.)
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